Looking Back
by werforpsu
Summary: This starts with a one shot of Alex Karev looking back at the life he has been blessed with. Subsequent chapters are glimpses into the life that the one shot explains. Story is listed as complete, but I am still adding new 'glimpses.' Cannon through S12E9. This is a Meredith / Alex romance.
1. Chapter 1

AN: Alright, after some rude reviews, here is my full disclaimer and opinion: This is a Meredith and Alex romance. Derek is dead and Meredith is allowed to move on. They aren't ACTUALLY brother and sister, so NO it isn't gross or incest. This is my story and I will ship whomever I want to. If you don't like it, don't read it. I am not the creator of this show, but I am the creator of this story. I don't care if the writer said that this relationship would never happen, there are a lot of relationships that would never happen, but they are still written about in fanfiction. If you are a MerDer person...I'm sorry, but he is dead, so your ship...has sailed. That being said, if you want to write your own MerDer story where he is alive: go for it, I'm not stopping you, so don't be rude to me.

I will remove inflammatory reviews from my story. You are allowed not to like it and you are allowed to say so, but I am not going to leave rude and inflammatory reviews attached to my story.

I DO hope you like my idea though. I know that some of the best fanfic stories I have ever read were with a ship that made me start out saying "WHAT?"

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If anyone had told Alex Karev 15 years ago that this would be his life, he would have laughed in their face. Even 10 years ago, this outcome would have been laughable. Here he was, head of pediatric surgery at Grey Sloan Memorial Hospital, married to his best friend, a father of five, and all-around happy with his life.

10 years ago when Derek Shepherd died, Alex didn't know if Meredith Grey would ever smile again. Nine years ago, Alex asked Jo Wilson to marry him. He never realized that her saying no was going to be the best thing that ever happened to him. His life changed eight years ago when he kissed Meredith Grey first time. By that point, Amelia had moved in to her brothers dream house with Owen and Maggie was recently engaged to Andrew DeLuca. Maggie and Andrew were househunting leaving he and Meredith along with her children the only people left in the old house.

He hadn't been with anyone since Jo, and Meredith had not been with anyone since Derek. They fit together well, a surprising thing considering they had never entertained romantic thoughts of each other ever before. Of all the people that Alex had been with over the years, Meredith was one person he had never truly considered being with. From the moment he met her, she was taken.

They got married at the courthouse six months after their first kiss. Neither wanted to have a big affair, both just wanted to live their life together. Considering Meredith's age, and her previously identified "hostile uterus," they were not sure that she would ever become pregnant again. They considered adopting another child, Meredith was adamant that Alex get a chance to be a father. The truth was that he was the only father that Ellis or Bailey remembered. Zola remembered Derek, but she needed a daddy, and Alex was happy to fill the role. Two years into marriage, Alex and Meredith adopted Isaac Joseph Karev, another African baby in need of medical attention. Just six months after the adoption for Isaac was finalized, Meredith discovered she was pregnant with another little girl. Alexandra 'Lexie' Margret Karev was welcomed into the world on a rainy summer night. Lexie was almost 4 1/2 and a true brainiac, just like her aunt and namesake.

It was incredible to think about their family. They had a niece and two nephews through Amelia and Owen. They had two nieces through Maggie and Andrew. Their children had a grandfather in Richard Webber that neither Meredith or Alex had seen coming. At Thanksgiving, the old home became filled with over 20 people, people who were all family, whether related by blood or not. Alex truly enjoyed his life. He was blessed in a way he had never thought was in his future.


	2. Chapter 2

AN: Thanks to everyone who reviewed and enjoyed the oneshot. Some people were interested in a novel length story, expanding upon it. I'm not sure that I will do a whole novel, but here is a chapter based on that 'universe.' It is simply another oneshot...a single event that occurred within the parameters of the original story. I may have a few more chapters to add after this also.

I'm sorry to the reviewer who doesn't think that Meredith and Alex could ever be a couple. They used the words gross and incest to describe the idea of them being together. I don't see anything wrong with best friends falling in love so I am going to keep writing them together. ENJOY!

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Alex Karev walked up to his front door at the loft he shared with Jo Wilson. Meredith was finally out of the hospital and settled in at home with her kids and Maggie. It had been a long seven weeks since her attack. He had moved in to Meredith's house, taking care of the three kids with the help of Maggie. Alex hadn't hesitated to take on that role the past seven weeks. He was Meredith's person. Maggie had been a huge help, especially with Ellie and whenever Zola's hair needed done.

Still as he stood there, trying to decide if he should knock or not on his own front door, he couldn't help but feel a little empty. Tonight when it was time for bed, he wouldn't be reading bedtime stories to Zola and Bailey. He wouldn't be tucking them in, and giving them kisses goodnight. He wouldn't be falling asleep in the rocking chair while he rocked Ellie to sleep. Tomorrow morning would be breakfast on the go. There wouldn't be pancakes and the laughter of kids that made you smile no matter how tired or cranky you felt.

Jo still hadn't answered his marriage proposal. They had been walking on egg shells around each other for the past seven weeks at work. Her previous complaints about his time spent with Meredith instead of her, all but disappeared. There wasn't much that Jo could have said, Meredith was in the hospital and her kids needed care. It would have been a really crappy thing for her to complain about given the circumstances. Now as he was faced with returning to the loft, Alex knew that they would need to discuss everything that had happened and what was to come. She would return to wanting him to spend less time with Mer and more with her. The fights were still there, they just needed to be brought up again.

Alex knocked. "Hi," Jo said when she opened the door.

"I wasn't sure if I should knock. You didn't know that I was coming."

"It's fine, come on in." Jo glanced at his suitcase, "does this mean you're going to stay here again?"

"If it's okay with you."

"Yeah. It's okay."

Three days later, Alex was pulling his hair out. They still hadn't talked, at least not more then a few words to each other. Alex came home after a long day to find Jo sitting at the table, suitcase next to her. "What's going on?" He asked sitting down at the table.

"Steph and I need to study for the boards, they are in two weeks. I'm going to go stay with her so that we can study constantly."

"Oh."

"There is something else that I wanted to talk to you about," Jo said, biting her lip.

"Okay," Alex replied, not liking where this was going. He could really go for a beer but he had drunk the last one the previous night and had been too tired to stop for more. He was regretting that decision now.

"My interviews for a fellowship went really well, especially at the Cleveland Clinic and Hopkins. An Ortho fellowship is two years and even though I could study under Callie, I've decided to leave Seattle." Jo sighed and placed the ring box on the table, open with the diamond still inside. "I'm sorry, my answer is no. I don't want to get married at this point in my life. I don't want to be tied down." Alex said nothing, just stared at the ring. "Once I decide where I am moving to, I will come collect the rest of my belongings." Jo stood and grabbing her suitcase, walked to the front door. "Bye Alex." She walked out and still, Alex said nothing. Ten minutes later, Alex riffled through the cabinets and found a bottle of tequila...that would do the trick.

The next day, Alex was at Meredith's. They were sitting on the couch and sipping coffee. Alex was explaining what had happened with Jo. "Just like that, she decided that the last five years meant nothing," he gripped. "Five years Mer! That's longer then the entire lifespan of my relationship with Izzy. In less then five years, Izzy and I met, hated each other, dated, married, fought cancer and got divorced! I really thought that this was it for me, that she was it for me."

"I'm so sorry Alex. I know how much this meant to you. After everything that you have been through, it would have been nice for you to not get your heart broken again." Meredith leaned over, putting her head on her best friends shoulder. He responded by placing his head on hers.

"Mer?"

"Yeah?"

"I hate the loft. All alone, it's awful." He admitted.

"Come back here," she said simply.

"I figured that you would be itching to get Ellie out of your room. You have four rooms and with just Maggie, you can spread out a bit."

"I'd rather have you here," Meredith offered. "I was already thinking about getting the attic finished. That would add a real bedroom for the future. Besides, you'd be helping me in the long run; another adult for the kids." Meredith pulled her head up and looking into Alex's eyes. "You always have a room with me. Always."

"Thanks," Alex said, kissing her forehead. "I'm going to take you up on it, if I spend another night there, I will need to drink and I'm on call."

"What are you going to do about the loft?" Mer asked, laying her head back on his shoulder.

"I'm not sure," he answered with a shrug. "Maybe just buy her out. I should have enough. I could rent it to a couple of interns or residents, or maybe just sell it."

"Buy her out. Then you won't have to deal with her at all about it. It will be your decision what to do with it."

"What about rent for living here? How much?"

"We'll work something out." Meredith said waving it off. "What Amelia was paying is fine. I don't need the money right now. The dream house and this one are paid for. Derek's life insurance policy was huge. Something about what he could have potentially made in his lifetime as a neurosurgeon. I'm making good money as a department head also. Just deal with Wilson and the loft, don't get behind on your loan payments and you can pay me when you have the money. I know that you are good for it."

"What about your loan payments? Don't you need to use Derek's money for that?" he asked with concern. He didn't want Meredith to suffer because of him. She had three kids to raise.

"I used my mother's life insurance for that. And Derek wasn't broke. He had a lot of money when we got married. Remember, all those years that we were residents and could barely afford anything, he was a department head making a department heads salary. The head of Neuro is one of the highest paid department heads in the hospital. He bought that land and put that silly trailer on it. It took us YEARS to build that house, it never put us into debt. Also Derek had been an attending for several years before he came to Seattle. Addison had her own money so she didn't get any of his in the divorce. I'm in the clear. Pay me when you can. Helping to raise my kids is enough," Meredith assured him.


	3. Chapter 3

Alex was the first one up on the warm May morning. He trudged downstairs and started the coffee. Everyone in the house would be up soon so he immediately took his cup of coffee and jumped in the shower. Their morning was beginning to have a bit of a routine. Alex would wake up, make coffee and get a shower. Once he was showered and dressed, he would go downstairs with Zola, Bailey and Ellie to feed them breakfast while Meredith and Maggie got ready. Then he would take the kids upstairs, getting the little ones dressed while either Maggie or Meredith would do Zola's hair. If Andrew was there, he would help entertain the kids while Maggie and Meredith finished getting ready. Then all seven of them would pile in Meredith's 'people mover' as she liked to call it, and head to the hospital. Once at the hospital whoever was needed the least took the kids to the daycare center. The kids would remain there until 9am when their nanny would arrive and take them for the day. She would return them to the daycare at 5pm and the first one of the doctors to get free would grab them. Luckily since Meredith and Maggie were department heads, usually one of them being free by 5:30 or 6 was no problem. It was a strange family that they had going on, but it worked. It supported Meredith without smothering her and gave the kids lots of stability when it came to the adults in their lives.

Their morning went as planned and they arrived at the hospital without incident. Today was the day that the fifth year residents were taking their boards. They had left the night before and Alex could only hope that this group had a less eventful day then their group had when they took the exam. Immediately after arriving, all available attendings were pulled in to the conference room to discuss the fifth year residents. They had twelve residents taking the boards that day. By the end of the day some of the residents would be getting ready to leave GSM hospital and set off around the country to begin as attendings and enter fellowships.

"Okay everyone," Miranda Bailey called out to begin the meeting. "The purpose of this meeting is to determine what departments are going to be short staffed once our residents obtain their boards. Each of our twelve residents has shown outstanding work while here and they have all been offered fellowships and attending positions here. Some will stay, but others will leave and to keep this hospital running in top shape, we need to figure out where we are going to have holes, so I can look through our national search applicants and pull out the ones we want to offer jobs to. This white board has the names of all the residents. Let's work through this."

"Let's start with those we know," Owen Hunt offered.

"Stephanie has indicated that she wants to stay," Amelia started. "She is interested in a Neuro fellowship." Bailey wrote neuro next to Stephanie's name and then circled it before looking expectantly at the attendings for more information.

"Kyle Baxter is leaving," Meredith offered. "His wife got a job in Huston, he is going there to pursue General Surgery."

"Jessica Willburn is planning to go to LA," April added in. "She has family there and her interest in trauma is right up their alley."

"Kevin Jacobs and Erica Black are going in to private practice," Owen threw out. Each time they said a name of someone leaving, the chief would erase their name from the board.

"Catherine is going to start here full time, heading up the urology department. She is bringing a second year fellow with her," Richard threw out, mentioning his wife.

"Ben is staying," Miranda Bailey said, circling her husband's name. "He is going to do a Plastic Surgery fellowship with Dr. Avery."

"What about Jo Wilson?" Jackson asked, causing everyone to look at Alex.

"She's leaving," he said simply. "I don't know where she's going and I don't care." Bailey erased the name from the board, wondering what had happened. Wilson was the resident she had been most sure would stay, other then Ben.

The remaining names were gone through systematically, with only one more name, Mary Brenner, getting circled. She would be going in to Neonatal and Obstetrics, doing a fellowship under Arizona. They still had question marks next to a few names, but now Bailey could get started with her search for fellows.

"Okay, that is everything," Bailey announced. "I need board members and Dr. Karev."

Once the other attendings had filed out, Alex was left looking at the faces of all the board members. The twinkle in Meredith's eye was the only thing keeping him from getting agitated.

"We have two things to discuss," Jackson Avery said, taking over the meeting. He looked expectantly at Alex. "First is the position of Head of Pediatric Surgery. Dr. Robbins will be taking over as the Head of Fetal and Neonatal medicine. This means that she is no longer able to be the Head of Pediatrics. Though she is going to remain a pediatrics attending for now, we will begin looking for an additional pediatrics attending. We would like to offer you the department head position. It would come with a pay raise and obviously you would have a lot of say in who the new pediatrics attending and fellow would be. Are you interested?"

Alex was struck silent for a minute before he blurted out, "Yes, I would be very interested."

"This is your proposed contract, look it over and get back to Dr. Bailey," Jackson said passing Alex a folder. "Second order of business. You were previously interested in becoming a board member of this hospital. At the time, we only had one available space and that spot went to Dr. Bailey. The seat previously occupied by Derek Sheppard needs to be filled. Meredith requested that we revisit your desire to become a board member before considering anyone else. We have already voted and would like to offer you the spot if you are still interested."

"Yes, I would be interested. Thank you for thinking of me," Alex said flabbergasted.

"Excellent. That ends this meeting."

Everyone else filed out of the room, leaving Alex with Arizona and Meredith. "You guys could have told me about this."

"That's not allowed, you know that," Arizona offered with a chuckle. "Obviously, you and I are going to be working together a lot, but I will only be operating on ped's patients if it is an emergency. Otherwise, the ped's department is yours to do with what you wish. I've already moved my stuff to the OB wing, you get my old office." Alex chuckled. It wasn't much of an office, ped's department heads weren't known for getting to sit down a lot. It was a small office where Alex would be able to meet with his fellows and parents of his patients. Even then, they often met in the NICU and PICU since the tiny patients required a lot of supervision. "I'll go over all the administrative stuff with you when we get a little time. Until then, just remember that it will be your responsibility to put forth any ped's specific supply needs. All the other supplies will be ordered through the general surgery budget. You just need to make sure that you have a good supply of pediatric intubation kits and such." Arizona gave him a hug. "Congrats Alex, you deserve all this." As she was walking away, she called back. "Find me later and I will walk you through your department head packet, make sure that you are getting what you deserve. I didn't see what they offered you, but you should always remember."

"We work on the little people and everyone loves the little people," Alex called back.

"You got it."

"Sorry I couldn't tell you, I was sworn to secrecy," Mer offered with a smile. "I'm glad that everyone agreed to give you the board seat. It was a unanimous vote."

Alex got a serious look on his face. "Mer, I know that you went out on a limb for me. I promise that I will not screw this up."

"Alex, it has been a very long time since you screwed something up. You are not that guy anymore," Meredith said sincerely. "When you started here, you wanted money. You wanted to be a plastic surgeon and make a bunch of money. But along the way, you changed into the man you are today. You don't sleep with every girl you meet; you aren't a doctor purely because of the money. You care. You care about patients, their families and your colleagues. You are helping me raise my kids Alex! You are a good guy, a great guy," she said emphatically. "You will be awesome as a department head and on the board."

"It's weird," Alex said as they left the conference room. "After I got my heart broken before, I always started sleeping around to help get over it. This time, I have no desire to screw nurses and interns and everything that moves."

"You've changed into a good guy." Meredith said again.


	4. Chapter 4

AN: So far, this is everything I have written on this 'world.' That means that I have no idea on the time frame for another update...we will just have to see if I get inspired!

This chapter was a little difficult to write. I could see it in my head but putting pen to paper was hard. This chapter includes the realization that they are attracted to each other. Going from friend to romance is a bit awkward so I hope that I captured that in this chapter.

Thanks for all of the great reviews. I am glad that you seem to be enjoying the strange tangents of my overworked mom brain!

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It had been a year. A year since Jo had turned Alex down and he moved back in with Meredith. A lot had happened recently. Andrew had asked Maggie to marry him. The two, who had been living in the old house with Meredith and Alex, had just moved in to Alex's loft that he had been renting to some interns the previous year. They were stepping towards a house, but wanted to rent the loft for a year first.

Meredith had decided to go ahead and have the attic finished a few months ago and the contractor had just put the finishing touches on the third story bedroom with its own bathroom. Once the kids were bigger, Meredith knew that she would appreciate the extra bedroom and bathroom space. Plus, Alex was still living with them. Meredith was fine if he never left, but it did mean that a fifth bedroom would become handy.

That day found Alex being the one ready to leave the hospital at a reasonable hour. Meredith had gotten pulled into a whipple that afternoon, she wouldn't be home until midnight. Luckily, Alex had been called in to the hospital by his fellow, Laura Brite, early that morning, so they had two cars at the hospital. Alex switched keys with Meredith, putting his in her locker before grabbing hers and sending her a text. He knew that the scrub nurse would relay the message. 'Switched keys, taking kids home. Later.'

Alex grabbed the three kids from the daycare and loaded them into the car. He hit the drive through on his way home so that they would all have something to eat. He was great at cooking pancakes, but he wasn't great at dinner.

Before he knew it, the kids had been bathed and we're getting settled for bed. He tucked in Zola and Bailey before taking Ellie in to Meredith's room. The plan was to move Ellie into Maggie's old room the next weekend, but for now, her crib was still in Meredith's room. Alex sat in the rocking chair with the eighteen month old and read her a story. She seemed wide awake, so Alex fell back on Meredith's standby which was to lay the little girl on the bed and lay next to her. Meredith would rub her back until sleep overtook her. Alex had been up early that morning and had spent a good portion of the day in surgery. He was exhausted and as Ellie fell asleep, so did Alex.

Meredith arrived home just before midnight and quietly padded through the house. She checked on Zola and Bailey, fixing the younger ones blankets which had all fallen to the floor due to his movement. It was a warm night so instead of covering him with all the blankets, Meredith placed them at his feet, ready to be pulled up if needed. Meredith saw Alex's open bedroom door and empty bed. This meant that she wasn't very surprised to quietly enter her room and see Alex and Ellie sharing her bed. The lights were off, but Alex had left the bathroom light on, casting a soft light on the bed, enough to keep the eighteen month old from getting scared of the dark. Meredith entered her bathroom and closed the door. She changed into a tank top and shorts to sleep in, brushed her teeth and threw her hair in a ponytail. Re-entering the bedroom, Meredith scooped up her daughter, kissed her head and deposited her in the crib. The little girl didn't stir. Meredith looked at Alex. He must have been exhausted. Usually he didn't fall asleep while putting the baby to bed. She hated the thought of waking him and sending him to his room. At this point, he had probably been asleep for almost four hours, enough to make it difficult to go back to sleep if he was awoken. Meredith did away with any thoughts of waking him and just climbed into bed next to him. The sheets were all pooled at the bottom of the bed where she had left them that morning. She grabbed just the sheet, leaving the blankets off due to the warmth, and pulled them up over her. Meredith sighed and was asleep as soon as her head hit the pillow.

Alex wasn't sure what woke him. It was Sunday and he and Meredith were both off that day. It was barely light out, so Alex knew that the sun didn't wake him. Just then Alex realized that what woke him was the woman whose body was pressed tightly against his. Meredith was draped over him, one leg hitched up and over his thigh, one arm across his torso, holding him tightly to her. There was no getting out of her bed without waking her, and judging by the weak morning light, it was barely six in the morning. That meant that she hadn't been asleep that long. Alex, let his eyes drift shut again, intent on going back to sleep. Just then, Meredith shifted, her leg rubbing against him. Arousal coursed through him and Alex had to stifle back a groan. It had been a long time since anyone had touched him, a long time since he had sunk himself deep within a woman's body. Alex took a few breaths as his arousal subsided. He told himself that his body only reacted that way because of how long it had been. Still as Alex fell asleep, his thoughts strayed to the woman pressed up to him.

It was a sunny morning that Meredith first woke up to. The sun was streaming in through the bedroom window. The house was still quiet. Her kids were champions when it came to sleeping in on lazy mornings. Meredith was about to roll over onto her back when she realized that she couldn't because she wasn't alone in bed. She was being spooned, Alex's body pressed against her back, his upper leg intertwined with her own. Meredith's tank top had risen during her sleep and Alex's hand was resting against her upper ribs, just below her breast. Even though he was asleep and didn't know what he was doing, it was the most intimately that anyone had touched Meredith since the death of Derek. Meredith felt Alex shift behind her and she realized that his hard length was pressed against her ass. Meredith groaned quietly as she felt her arousal heighten. She didn't know what this meant. She hadn't had sex in over two years. Was she just horny? Did she feel something for her best friend? Her breath hitched as his hand shifted and she was surprised to realize that she was hoping that his hand would go up to cup her breast. When his fingers brushed against the sensitive underside of her breast, Meredith was unable to keep the quiet moan inside.

Meredith could tell when Alex began to wake because his whole body tensed. She remained very still with her eyes closed. He was her best friend and she would rather spend the rest of her life as just his friend then for him to be disgusted that she had unknowingly developed feelings for him. She kept her body relaxed, feigning sleep as he softly swore and extracted himself from around her. Alex stood up and left her room quietly. When Meredith heard his bedroom door shut, she quietly got out of bed to go downstairs. She needed a cup of coffee. She needed to evaluate the fact that she had accidentally developed feelings for Alex. He was her person, her best friend. She hadn't seen this coming, but here it was.

Meredith tiptoed past his door but paused when she heard the unmistakable sound of him of him pleasuring himself. She was transfixed by the sound and couldn't help but lean towards the door and the sounds that he was making within. As Meredith heard him reach his climax, she was stunned to hear him whisper 'Mer." Meredith continued her way downstairs, cheeks flushed with arousal. She made a pot of coffee and splashed water on her face before she began getting out the ingredients for pancakes. Once the batter was prepared, Meredith sat down with her coffee to wait on Alex. He would be the one to make the pancakes, they were his specialty.

Meredith heard the shower turn off and a few minutes later, Alex walked into the kitchen, hair still a little wet from the water. "Morning," he said as he got a cup of coffee.

"Morning," Meredith replied. "I made the pancake batter, did you hear any sounds from the kids?"

"Not yet, but I'll go ahead and make them. They will be up soon."

Alex began with the pancakes and a few minutes later Zola and Bailey raced into the kitchen, "PANCAKES!" Bailey exclaimed.

"Is your sister awake?" Meredith asked Zola.

"Yep, I told her that I would get you," the little girl said, climbing up to the table and grabbing the syrup before Alex could even give her a stack of pancakes.

Meredith made her way upstairs, got Ellie out of her crib and changed her before going back down stairs and plopping the little girl in her high chair. Alex was on the ball and placed a plate of cut up pancake and a cup of milk in front of the little girl seconds after Meredith sat her down. Meredith grabbed a second cup of coffee and was momentarily transfixed by Alex and her children. He was back and the griddle making more pancakes, the kids laughing and carrying on at the table. Meredith debated in her head for a moment what she was about to do. In the end, she decided that the risk was worth taking. Meredith made her way over to Alex, slipping between him and the counter, facing him she gave him her best smile. "Thanks for breakfast," she said quietly. She wound her hands around his neck and was pleased to hear his breath hitch. Meredith's eyes locked with Alex's. Her stomach started to do flips and she could tell his was doing the same.

"Mer," Alex whispered. It came out like a plea and before she knew it, she and Alex were sharing their first kiss.

After they broke the kiss, Meredith leaned her forehead against his. "We have to talk about what this means," she whispered.

"We do," he replied.


	5. Chapter 5

AN: I'm sorry that it took me so long to get this to you. I had it written in a matter of hours, but I was trying to get you a different chapter first. I have been going in chronological order and wanted to write about Mer and Alex telling the staff at GSM, going on their first date, their first time having sex etc. I tried for a week and the words didn't flow well, SO I am just going to continue with what my mind threw out in the first place.

This chapter was personal for me. This chapter focuses on the developing relationship between Alex and little Ellis and how easy it is due to her young age. As an older child or adult, when one parent dies and the other gets remarried it can be extremely difficult to accept the fact that this new person has a permanent place in your life. Watching how easy it was for my young children to adjust to a new grandparent was a bit heartbreaking. Young children have a beautiful innocence that allows them to take people as they come and be completely accepting. My children welcomed an ADDITIONAL grandparent but were not trying to replace the one they lost. This chapter (and any that follow it) are not trying to undermine Derek's position as the kids father. The advice that Maggie gives Meredith is real advice that my sister and I received when my mother got engaged just one year after loosing my father.

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Alex had to find Meredith. He was freaking out a little bit. They had been a couple for two months and everything was going very well. It was timid and awkward at first but in no way uncomfortable or wrong. Alex thought back to George and Izzy and their disastrous coupling. It was TOO awkward in that case. Alex wasn't sure why this new relationship with Meredith was any different. He had known Meredith for a long time and while he could have always admitted that she was hot, he had never truly thought about going after her. He had been broken back then. Once he FINALLY felt like he wasn't broken, Izzy had crushed him to his core and once again, he was broken. Still, he hadn't been that man in a long time. If his relationship with Jo had taught him anything, it was that the broken man, who used sex as a defense against the world, was gone. After Jo, he didn't go crazy and have sex with the entire nursing staff, he didn't screw the new interns, and he didn't pick up women in a bar. Alex had just moved on with his life after Jo.

On that particular day, Meredith had been called in to the hospital at four in the morning for an emergency appendectomy. That left Alex to get the kids ready and to the hospital. He was very comfortable doing that, it wasn't the first time. And then it happened. He dropped the kids off at daycare and Ellie gave him a big hug. "Bye bye dada," the twenty month old babbled before toddling off to play.

'Dada.'

He had tried to prepare himself for it, he specialized in kids and he knew that it would happen. She was too young to think any differently; most likely a new daycare worker had referred to him as 'dada' without even realizing the error. Other kids probably said the word all day long and she heard them. He didn't mind being her dad, he didn't mind being dad to all three of them...but...would Meredith mind? Alex had talked about this possibility with Arizona just last week and she recommended talking to Meredith. They had gotten busy, Zola had a cold, and talking about his girlfriends kids calling him dad had drifted from his mind.

Meredith had just finished surgery when Alex found her. "Do you have a minute?" He asked.

"Sure, everything okay?" She asked as he pulled her into an on-call room.

"Yeah, but I wanted to talk to you about something."

"What's up?" Meredith asked, confused by his pacing.

"Ellie called me 'dada' this morning," Alex blurted out as he paced in front of her. "And I'm okay with it, I kind of like it actually, but we never talked about it and I don't know how you feel." He looked at her with vulnerable eyes and Meredith's heart went out to him. Even though they hadn't discussed it, she had talked to Maggie and Amelia about it extensively. It was a hurdle for her emotionally, but the acceptance of her sister and sister in law was a huge weight off of Meredith's shoulders. Meredith thought for a second how differently this conversation might go if she had been blindsided by it.

"It's fine. I like it actually," Meredith said pulling him down next to her to sit on the bed. "I know it is a little strange, but I think its fine. Maggie and I talked about it and she said something very enlightening to me. You are not replacing Derek, but… Is it better for them to have a dead biological father and no other father, or is it better for them to have someone that fills that place in their life? Whether you and I are together or not and whether you become their dad or not; it doesn't change the fact that Derek is dead. It is better that they have someone. If I had died, I wouldn't want the kids to grow up without a mother's love. I would want someone to love them as a mother. Zola, in particular, might never call you dad, but that is okay. We just let them do what feels right."

"You are incredible," Alex whispered. "When enough time has passed, I'd like to get married," he said hesitantly. "Maybe adopt the kids if it's okay with you. I wouldn't want to change their last names or anything. Just adopt them so that I can make decisions in an emergency."

"Yeah," Meredith replied with a smile. "Maybe adopt another little one. Give them the last name of Karev."

"I'd like that," he said with a grin.

That night Alex was putting Ellie to bed in her room while Meredith was talking to the older two about calling Alex dad. They were being given free reign to call him by either moniker and allowed to change their mind at any time. It was being explained that Ellie had already began calling him 'dada' so they were not surprised.

"And he found his supper waiting for him, and it was still hot," Alex read. Ellie's favorite story wasn't about bunnies or something soft and cuddly, it was 'Where the Wild Things Are.'

Ellie began to quietly protest even as she was yawning, "more?" She asked Alex, holding up the book.

"Not tonight El Bell," Alex said calling her his special nickname for her. "You need to get to bed. Mommy and I have to work tomorrow."

"Mama Dada urk?" She asked, stumbling a little on the word work.

"Yep, Mama and Dada have to work tomorrow," he responded. His heart had swelled hearing her call him dada again. "I love you El Bell," he said standing up with her in his arms and giving her a squeeze and kiss before placing her in the crib.

"Wuv oo Dada. Nigh nigh," the little girl breathed out as she got comfortable and pulled her stuffed puppy into her arms.

"Night night Ellie," Alex whispered as he shut of the light and pulled her door shut most of the way.

He found Meredith in their room getting ready for bed. "How are the big two?"

"Tired."

"What did they say about the dad thing?"

"Not too much. Bailey seemed almost relieved that he was allowed to think of you that way. He doesn't remember Derek, you are the only dad he knows. I wouldn't be surprised if he switches over to calling you dad immediately," Meredith said, sitting on the bed and beginning to get under the covers.

"And Zola?"

"She was quiet and thoughtful about it. We will have to wait and see what she decides."

As Alex started changing into shorts and a t-shirt, Meredith was quiet and contemplative. As he got in bed, Meredith snuggled into his arms and started to speak. "If anything happens to me..."

"Nothing is going to happen to you Mer," Alex whispered.

"Alzheimer's could happen to me," she countered. "Or a bus, a car accident, a plane crash, deadly hiccups, cancer," Meredith added, listing some of the things their friends and family had suffered from in the past decade or so.

"We will cross that bridge when we get to it," Alex replied, dropping a kiss on the top of her head. "Mer, Alzheimer's has always been a possibility, but that's all it is."

"It's just that you becoming their adoptive dad means that you are going to be responsible for them if I loose my marbles."

"Being their dad doesn't change that. I was always going to be responsible for them. When we were just friends, I was still your person. Before, I would have shared them with Maggie. Now, she would just be helping me. Nothing has really changed."

"So, even with already having three kids and my potential for Alzheimer's; you still want to see about adopting another baby?" Meredith asked with trepidation.

"Baby Karev has a nice ring to it don't you think?" he asked, smiling more as he thought about it.

"Yeah, Baby Karev has a nice ring," Meredith agreed.


	6. Chapter 6

Thank you to all who have read and reviewed. Your comments mean so much to me!

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The PICU was quiet except for the sounds of the machines beeping. It was three in the morning. The parents of the little patients were sleeping in recliners or at home with their other children. Alex Karev was not on call, but was here anyway. He was in a recliner holding his new son. Isaac Joeseph Karev was three months old and was recovering from surgery to correct a cleft lip. He, along with nine other children, had come to GSM hospital from Africa for a continuation of Alex's 'Africa Project' that he began as a resident.

The little boy was sleeping soundly and Alex began reflecting on how this moment came to pass.

 _Alex entered the board meeting along with everyone else. He and Meredith sat together; they had been married for about eighteen months. Bailey went over the usual information, but Alex had barely heard her. He had received a call that morning from a contact that he had in Malawi. They had more children who needed medical care and the procedures could not be done anywhere but the US. These children would likely die if their medical problems were not treated._

" _Does anyone else have any additional business?" Bailey asked, opening the floor to the rest of the board._

" _I would like to re-open the 'Africa Project' from my residency," Alex blurted out. "Obviously we can't treat every child in Africa, but we can make a difference in the lives of some. I would like to consider bringing over six or so children once or twice a year. We would have to find financial donors and do fundraising; but this is important work, work that could convince other hospitals to follow in our footsteps, paving the way for more children to get treatment."_

" _I wasn't here the last time this program was implemented. What do you need to make it happen?" Catherine Avery asked, glasses perched on the end of her nose._

" _Last time it cost about $200,000 to bring ten kids and a relative to the states and have the patient and relative stay for the duration of the surgery and recovery. The hospital staff who treated the children were all volunteers. The hospital donated the use of the OR's and the financing covered any additional surgical cost."_

" _$200,000 is not that much money when it comes to hospital programs," Catherine commented. "Obviously, the donations of these OR's as well as the staff of this hospital helped keep costs down dramatically. The Avery Foundation would be willing to cover this round of the project assuming that you would be willing to work diligently with me on fundraising for the future, Dr. Karev."_

" _I will do whatever it takes to get these kids the medical care that they need," Alex assured her._

True to her word, Catherine Avery donated the funds to bring the first group of children to GSM hospital. It took five months to arrange it, during which time Catherine taught Alex how to seek donations for future groups of children to come.

A month ago, ten children were brought with a family member or care giver to receive their surgeries. All were recovering nicely, many had returned to their homes. Little Isaac, just two months old had entered the hospital to have his surgery but he had a cold and they decided to wait to perform the surgery when he was better. He was brought by a caretaker at an orphanage. He had a cleft lip and his mother had abandoned him. Just two days after he arrived, Alex found Meredith in the PICU rocking the baby to sleep.

" _He's perfect," Meredith breathed out, rubbing the baby's back as he slept on her chest. Alex said nothing and just raised his eyebrows at Meredith indicating he wanted her to explain. "When Derek saw Zola, he knew instantly that he wanted to take her home. I was unsure, worried about my abilities, but he knew. I saw Isaac in here and I just had to hold him. Alex, I can't explain it, but I just KNOW that he belongs with us!"_

" _You want to adopt him?" Alex asked with surprise._

" _He's an orphan."_

" _I know," Alex said. "We said we liked the idea of another baby," he offered._

" _So it's okay with you?" Meredith asked with excitement._

" _It's okay with me," Alex confirmed. "If you're in, I'm in."_

" _Then I have some phone calls to make," Meredith said, standing up with the baby in her arms. "Here, you sit here with him for a few minutes. Hold him and breathe him in and you will fall in love instantly."_

" _Mer, I hold babies every day," Alex chuckled taking the baby with her._

" _This will be different, trust me."_

And she was right, so every day Alex would take a break from his day and go hold Isaac. The adoption was finalized just three days ago, right after the little boy's surgery. Each day since, Alex or Meredith would stay the night at the hospital, holding him when he cried and sleeping in the rocker next to his bed. He would be going home that morning, home with them.

Just that morning, Alex attended and spoke at a press conference to publicize what they were doing.

" _This past month, Grey Sloane Memorial Hospital brought ten children from Africa to receive surgeries that would cure them of life threatening medical problems that could not be treated in Africa," Alex spoke to the assembled group of reporters, cameras in his face. The staff of this hospital donated their time to care for and perform the surgeries needed to help these children. As of two days ago, the last surgery was performed successfully. As the head of Pediatric Surgery here at Grey Sloane Memorial Hospital, I am asking for your donations to allow this program to thrive and save more children. Every dollar counts. I am going to give the microphone to our Chief of Surgery, Dr. Miranda Bailey who can answer all of your questions about how and where to donate. Thank you."_

Alex breathed in the new baby smell and closed his eyes. It was a perfect smell to fall asleep to, his new son in his arms.


End file.
